Residents in long-term care communities are more likely to be healthy and avoid injury when they are cared for by fully staffed teams of RNs and caregivers. Unsurprisingly, residents of communities that struggle with high turnover of RNs and caregivers are at greater risk of infection and hospitalization, according to research published in the Journal of the American Geriatrics Societyemployee turnover

Sheryl Zimmerman, PhD, and her team of researchers at the University of North Carolina and the University of Maryland, studied a random sample of 59 nursing homes in Maryland. Through interviews with staff at the facilities and direct observation of the patients, the researchers found that the numbers of infections diagnosed were significantly correlated with the facility’s RN turnover rate. High turnover of registered nurses was also associated with higher rates of patient hospitalization for infection.

study carried out by Nicholas G. Castle, PhD and John Engberg, PhD at the University of Pittsburgh, found that the quality of care decreased significantly when the turnover of registered nurses increased from a low level of 0-20% to a moderate level of 21-50%. They also found that decreases in quality of care were associated with increases in the turnover of nursing assistants and licensed practical nurses, although in this case the effect was most significant when the turnover rate rose above 50%. The best quality of care was associated with levels of nursing staff turnover of less than 20%. Over time, low standards of care can damage the reputation of a long-term care facility, leading to lower earnings or even fines from regulatory bodies such as the Centers for Medicare and Medicaid (CMS).

The Castle and Engberg study mentioned above reported that the average turnover rate for registered nurses was 55.4%, while turnover rates for licensed practical nurses and nursing assistants were even higher at an average of 85.8%. However, the authors also noted that there were very large variations in staff turnover rates among the 354 nursing homes that responded to the survey. Clearly, some long-term care communities are better able to retain a stable staff of registered nurses and nursing assistants.

Through the use of talent management technology, such as behavioral assessments and applicant tracking software, long-term care facilities are able to prevent turnover and maintain adequate staffing levels of RNs and caregivers to provide high-quality care for residents. In order to make better hires and prevent turnover, talent acquisition professionals should consider implementing behavioral assessments into their recruitment process. With behavioral assessments, talent acquisition professionals will be able to make better hires by assessing candidates for their inherent behavioral competencies such as compassion and customer focus to align with the organization’s culture. When a behavioral assessment survey is given to a candidate, they are asked questions that are meant to solicit answers that will reveal how they will perform on-the-job and act in certain situations.

Aside from preventing turnover, long-term care facilities must ensure that they maintain adequate staffing levels to provide a high level of care. Applicant tracking software allows recruiters to streamline their recruiting processes and ensure that they always have a robust candidate pool of potential nurses and caregivers to meet resident needs. Recruiters and hiring managers can set goals that can be used to ensure that they are meeting their time-to-fill goals to maintain adequate staffing ratios to meet the CMS quality rating requirements.

With the help of talent management technology, long-term care organizations will be able to fill open positions more quickly and increase new hire retention by integrating behavioral competencies into the selection process. The challenge for talent acquisition professionals in the long-term care industry is to strive to put in place practices that are known to keep turnover rates low, resulting in the delivery of high quality care and better outcomes for residents.


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Meghan Doherty

About Meghan Doherty

Meghan Doherty is a content marketing professional based in the Greater Boston area. She has more than five years of experience creating and managing content for SaaS companies in the healthcare and talent management spaces.